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Hepatocellular carcinoma in Australia’s Northern Territory: high incidence and poor outcome

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Hepatocellular carcinoma (HCC) is a devastating complication of chronic viral hepatitis. It is the fifth most common incident cancer in the world, and the second most common cause of cancer death.1,2 HCC is among the fastest growing causes of cancer incidence and mortality in Australia,3,4 but its epidemiology in northern Australia has not been comprehensively described, and there are no published analyses from the past decade. Past reports of the incidence of HCC in the Northern Territory have shown it to be higher than the national level and 6–10 times higher among Indigenous Australians than non-Indigenous Australians.5,6 However, previous studies have been based only on registry data and have not described the clinical features and management of HCC in the NT.

The NT has a population of about 230 000 people, of whom 30% are Indigenous. Indigenous Australians have higher rates of chronic hepatitis B virus (HBV) infection than the general Australian population. Recent NT studies have found seroprevalence estimates for hepatitis B surface antigen (HBsAg) in adults of 3%–12%,711